Position Summary

The Ambulatory Surgery Center Insurance Benefit Specialist ensures all scheduled surgical cases have accurate, complete, and timely insurance verification, authorization, and financial documentation. This role supports clean claims, helps prevent denials, and ensures patients receive accurate financial estimates prior to their procedure. The Insurance Benefit Specialist may be cross-trained in other functions of the business office.

Responsibilities

• Verify insurance information, including authorizations, benefits coverage, and claims mailing address; document all data in the HIS.
• Review and correct insurance information in the HIS, including deductible, co-payment, and patient payments due at time of service.
• Inform pre-admissions clerks and patients (when applicable) of any deductible, co-payment, or patient payments.
• Coordinate with Scheduling and Pre-Admissions for cancellations, additions, and schedule changes.
• Communicate with adjusters, nurse case managers, and benefits organizers regarding verifications and plan coverage.
• Collaborate daily with the Revenue Cycle Manager.
• Support accurate insurance entry, authorizations, claim numbers, and adjuster details in the health information system.
• Perform related work as required and assist with cross-coverage through cross-training.
• Complete software training as needed to stay current with information technology.
• Represent Amblitel professionally to facility administrators, business office and clinical personnel, physicians, patients, and vendors.
• Follow Amblitel policies and procedures and comply with HIPAA regulations.

Work Experience

• Minimum of 2 years’ experience with insurance benefits in an Ambulatory Surgery Center.
• GI experience required.
• Experience using a medical software billing system.
• Proficiency with Windows, Microsoft Office, and ASC software.

Education

• High school graduate or equivalent.

Preferred Skills & Knowledge

• Advantx or HST experience preferred.
• Ability to work under pressure.
• Excellent written and verbal communication.
• Strong prioritization and time management; able to meet deadlines.
• Ability to multitask.
• General understanding of healthcare environment and company products/services.
• Knowledge of alpha filing systems.
• Working knowledge of Medicare, Medicaid, Workers’ Compensation, and Managed Care.
• Working knowledge of out-of-network billing.
• Knowledge of medical terminology; basic knowledge of codes and modifiers.
• Ability to access and utilize the Internet.
• Familiarity with automated insurance verification applications used in healthcare.

Compensation

• $18–$22/hour